Radiologic biopsy system and method

ABSTRACT

A method of performing a radiological biopsy and associated system includes scanning a living human subject with a CT scanner to locate coordinates of an area of potential pathology and then using the coordinates to direct synchrotron radiation to a location at, or proximate the coordinates to obtain a high-resolution image of the area of potential pathology. The CT scan is accomplished with a CT scanner such as a C-Arm, vertical or horizontal CT scanner. A synchrotron radiation source emits synchrotron radiation through the subject and is processed by a processing system. The method and system allow for concurrent or sequential scanning of the subject by the CT scanner and synchrotron radiation scanner. The resulting images provide histological resolution of areas of potential pathology.

FIELD OF THE INVENTION

The invention generally relates to imaging systems and methods forradiologic imaging of biological specimens. More specifically, theinvention relates to a system and method for cooperative imaging withconventional/standard computerized tomography (CT) and synchrotronradiation to rapidly localize and perform an image-based biopsy oftissue at a cellular or subcellular level.

BACKGROUND

In general, conventional, or medical CT scanners use a rotating X-raytube and a row of detectors to measure X-ray attenuations by differenttissues inside the body. CT is based on the fundamental principle thatthe density of the tissue passed by the X-ray beam can be measured fromthe calculation of the attenuation coefficient. Using this principle, CTallows the reconstruction of the density of the body, by 2-D sectionsperpendicular to the axis of the acquisition system.

The CT X-ray tube (typically with energy levels between 20 and 150 keV),emits N photons (monochromatic) per unit of time. The emitted X-raysform a beam which passes through the layer of biological material ofthickness Δx. A detector placed at the exit of the sample, measures N+ΔNphotons, ΔN smaller than 0. Attenuation values of the X-ray beam arerecorded, and data used to build a 3-D representation of the scannedobject/tissue. There are basically two processes of the absorption: thephotoelectric effect and the Compton effect. This phenomenon isrepresented by a single coefficient. In the case of CT, the emitter ofX-rays rotates around the patient and the detector, placed indiametrically opposite side, picks up the image of a body section (beamand detector move in synchrony). Unlike X-ray radiography, the detectorsof the CT scanner do not produce an image. They measure the transmissionof a thin beam (1-10 mm) of X-rays through a full scan of the body. Theimage of that section is taken from different angles, and this allows toretrieve the information on the depth (in the third dimension). Theimage of the section of the object irradiated by the X-ray isreconstructed from a large number of measurements of attenuationcoefficient. It gathers all the data coming from the elementary volumesof material through the detectors. Using a computer and establishedalgorithms, it presents the elementary surfaces of the reconstructedimage from a projection of the data matrix reconstruction, the tonedepending on the attenuation coefficients.

The multiple X-ray measurements taken from different angles are thenprocessed on a computer system using reconstruction algorithms toproduce tomographic (cross-sectional) images or virtual “slices.” Fromthe 2-D X-ray, a scan range is selected, and multiple tomographic slicesare obtained.

During a traditional CT-guided biopsy, a so-called “scout view” is firstgenerated which is essentially a general X-ray of the body, in order toidentify a few key landmarks and roughly determine what level the areaof concern is located and what area to scan. Then, a subsection (or scanrange) is blocked off for slice acquisition.

Using conventional CT, a number of slices are obtained while the patienttable is translated through the gantry. Each slice corresponds to acertain table position, and by extension, a certain position of thepatient in the craniocaudal dimension. The ideal slice position isselected which displays the desired location to biopsy and the table ismoved to that position. The remaining locations of the lesion can bedetermined from the image itself. A biopsy needle is then advanced, andthe needle location is scanned incrementally to ensure correcttrajectory within the plane of the initial slice. By virtue of thatfact, however, the procedure remains invasive and still requires the useof a needle to ultimately obtain the tissue sample.

A CT machine for realizing noninvasive pathological diagnosis by using asynchrotron radiation light source has previously been proposed.However, there are limitations and obstacles heretofore inadequatelyaddressed to make it practically useful. These obstacles can be dividedinto those resulting from inherent properties of the synchrotron light(also referred to as “synchrotron radiation”) source and those relatedto the transition from fixable/inanimate specimens to living specimens.As to the former, the small cross-sectional size of the synchrotronlight source renders it unsuitable for initial localization due to thelarge area that would need to be scanned and subsequent prohibitivelylong scan times. As to the latter, transition to living biologicalsubjects present unique challenges, not the least of which is related tomotion during scanning. Even the most minute of movements can interferewith obtaining the necessary data for cellular level resolution.

There are several challenges which have traditionally been associatedwith synchrotron radiation and limit its practicality and usefulness asa radiologic tool. To begin with, a synchrotron, which is a type ofcircular particle accelerator, is typically very large (some as large asa football field). Second is cost, with some synchrotrons costing up to$200 million just to build the actual device (not including housing,maintenance, etc.). Thus, there are only a few (less than 100)synchrotrons around the world. Synchrotron radiation is generated whenrelativistic charged particles (ex. electrons) are accelerated in adirection perpendicular to their velocity. This is accomplished througha series of magnets until they reach near the speed of light. Thesefast-moving electrons produce very bright light, called synchrotronlight. The main properties of synchrotron light which set it apart fromconventional ionizing radiation include high brilliance, high level ofpolarization, high collimation, low emittance, wide tunability, andpulsed light emission. This very intense light, predominantly in theX-ray region, is millions of times brighter than light produced fromconventional sources and ten billion times brighter than the sun.Scientists can use this light to study minute matter such as atoms andmolecules. Other practical differences between synchrotron light sourcesand conventional CT scanners are the following:

A. Synchrotron light can operate as a monochromatic beam (thereforeeliminating beam hardening artifacts).

B. A synchrotron beam has a very small cross-section, with mostsynchrotrons generating a beam cross-section of only a few mm². Thereare exceptions, such as the Canadian Light Source synchrotron which canobtain a beam cross section up to ˜130×9 mm² beam. However, there areonly a few such facilities in the world capable of delivering similarlarger sized beams. According to experts in the field, however, eventhis is not enough to scan, for instance, a chest of a swine unless itis a very small piglet. Certain techniques can be used to effectivelyenlarge the examined volume by translating a sample in the beam but thenscan times become very long—sometime hours. At which point, itspracticality on live specimens becomes a major concern, with issues suchas motion artifact and the subsequent need for suppression measures suchas respiratory-cardio gating.

C. An added critical difference from medical or conventional CT is thatthe sample must be rotated along its long axis. Consequently, it is verydifficult to mount a sample on the CT stage—various contraptions must bedevised to immobilize the sample (again, at this point, motion artifactbecomes a major concern).

D. Synchrotron X-ray energy is limited to a range between approximately100-140 keV. Comparatively, medical scanners can extend their range upto 250 keV.

Generally, synchrotron radiation excels in microscopy applications dueto the small beam and very large photon flux density (ex. scanning amice embryo, in which individual nuclei can be seen).

Therefore, there is opportunity and need for improvements in how toperform radiologic assisted biopsies including use of synchrotronradiation to provide a high-resolution image of potentially pathologicalspecimens of living organisms, particularly suitable for detectingpathology in living humans.

SUMMARY OF THE INVENTION

The present invention couples conventional CT with synchrotron radiationas a substitute for needle based or invasive biopsy and is meant togenerate a slice of similar scale as a histologic/pathologic slice. Oncethe desired location is determined by conventional CT scan, the patientor specimen is translated so that the lesion may be aligned with thesynchrotron beam and permit scanning by synchrotron radiation. Thepatient is moved into position to permit synchrotron radiation to beapplied to a very specific area, analogous to that which would besampled in a needle biopsy. Synchrotron radiation allows for muchthinner slice generation than conventional CT. The synchrotron beamwould pass through that site and the “sample” is then obtained that willbe of histologic (microscopic) slice thickness, i.e., a radiographicbiopsy.

In a nonlimiting embodiment, the invention includes a method ofperforming a radiologic biopsy, including scanning a living humansubject with a CT scanner to obtain CT scan images of the living humansubject. Next is identifying in the CT scan images a localized area ofpotential pathology and identifying an X, Y and Z coordinates within thearea of potential pathology. Contemporaneously with scanning the livinghuman subject is scanning with a synchrotron radiation source the areaof potential pathology at, or proximate to the X, Y and Z coordinates.Next is obtaining a dataset of sub-micron resolution image data from thescanning with the synchrotron radiation source. Another step is computerenabled resolving of the dataset to produce a radiographic image havingcellular level resolution of at least a portion of the area of potentialpathology.

The method of performing a radiologic biopsy may also includerepositioning the living human subject before the step of scanning withthe synchrotron radiation source to line up the X, Y and Z coordinatesof the area of potential pathology with a beam of synchrotron radiationfrom the synchrotron radiation source.

The method of performing a radiologic biopsy may also include, duringthe step of scanning with the synchrotron radiation source, rotating theliving human subject.

The method of performing a radiologic biopsy may also include, where thesteps of scanning the living human subject with a CT scanner andscanning with the synchrotron radiation source are at least in partperformed concurrently.

The method of performing a radiologic biopsy may also include where theradiographic image is of comparable quality to a histologic slice of atleast a portion of the area of potential pathology.

The method of performing a radiologic biopsy may also include reviewingthe radiographic image for evidence of pathology.

The method of performing a radiologic biopsy may also include tuning asynchrotron beam flux and energy from the synchrotron radiation sourceprior to the step of scanning with the synchrotron radiation source toensure that the average energy is sufficient to penetrate through theliving human subject but low enough to allow fast scans.

The method of performing a radiologic biopsy may also include where theCT scanner is a C-Arm CT scanner, and where the C-Arm CT scannerincludes an unobstructed pathway for allowing a synchrotron radiationbeam from the synchrotron radiation source to traverse the unobstructedpathway, where a direction of the synchrotron radiation beam and adirection of the scanning of the CT scanner are orthogonal to eachother.

The method of performing a radiologic biopsy may also include where thesteps of scanning the living human subject with a CT scanner andscanning with the synchrotron radiation source are at least in partperformed concurrently while the synchrotron radiation traverses theunobstructed pathway.

The method of performing a radiologic biopsy may also include where theCT scanner is a horizontal CT scanner, where the horizontal CT scannerhas an unobstructed pathway for allowing a synchrotron radiation beamfrom the synchrotron radiation source to traverse the unobstructedpathway.

The method of performing a radiologic biopsy may also include where theCT scanner is a horizontal CT scanner, where the living human subject issupported on a horizontal stage, where the horizontal stage is movablein an X, Y and Z direction, and where the horizontal stage is adapted torotate in a rotisserie-type manner around an axis perpendicular to aplane of the horizontal CT scanner.

In a nonlimiting embodiment, a radiologic biopsy system of the inventionincludes a CT scanner adapted to scan a living human subject and provideCT scan images of the living human subject, where the CT scanner isadapted to provide an X, Y and Z coordinates of an area of potentialpathology within the living human subject. The system also includes asynchrotron radiation source, where the synchrotron radiation sourceemits synchrotron radiation and is adapted to provide a synchrotronradiation scan of the potential pathology at, or proximate to the X, Yand Z coordinates. The synchrotron radiation can be emitted through adirector, then through the living human subject, and then onto areceptor where the receptor collects data from the synchrotron radiationscan and communicates the data to a processing system adapted to processthe data and provide a histologic slice of at least a portion of thearea of potential pathology. The system also includes a stage adapted tohold the living human subject during both a CT scan and a synchrotronradiation scan.

The radiologic biopsy system may also include where the CT scanner is aC-Arm CT scanner, and where the C-Arm CT scanner includes anunobstructed pathway for allowing the synchrotron radiation from thesynchrotron radiation source to traverse the unobstructed pathway toperform the synchrotron radiation scan of the living human subject.

The radiologic biopsy system may also include where the unobstructedpathway is an aperture in an arm of the C-Arm CT scanner.

The radiologic biopsy system may also include where the scan of theliving human subject with a CT scanner and scan of the living humansubject with the synchrotron radiation source are concurrentlyperformable.

The radiologic biopsy system may also include where the CT scanner is ahorizontal CT scanner, and where the horizontal CT scanner includes anunobstructed pathway for allowing the synchrotron radiation from thesynchrotron radiation source to traverse the unobstructed pathway toperform the synchrotron radiation scan of the living human subject.

The radiologic biopsy system may also include where the CT scanner is ahorizontal CT scanner, where the stage is horizontal and movable in anX, Y and Z direction, and where the stage is adapted to rotate in arotisserie-type manner around an axis perpendicular to a plane of thehorizontal CT scanner.

The radiologic biopsy system may also include where a direction of thesynchrotron radiation and a direction of the scanning of the CT scannerare orthogonal.

The radiologic biopsy system may also include where the directorincludes one or more of a series of reflectors, refractors, slits,collimators and radiation shutters capable of directing and alteringcharacteristics of the synchrotron radiation.

The radiologic biopsy system may also include where the directorcomprises fiberoptics adapted to transmit the synchrotron radiation, andwhere the synchrotron radiation source is remotely located to the CTscanner.

In another nonlimiting embodiment of the invention, a radiologic biopsysystem includes a CT scanner adapted to scan a living human subject andprovide CT scanned images of the living human subject, where the CTscanner is adapted to provide an X, Y and Z coordinates of an area ofpotential pathology within the living human subject. The system alsoincludes a synchrotron radiation emitter, where the synchrotronradiation emitter emits synchrotron radiation and is adapted to providea synchrotron radiation scan of the potential pathology at, or proximateto the X, Y and Z coordinates, where the synchrotron radiation isemittable through a director, then through the living human subject, andthen onto a receptor where the receptor collects data from thesynchrotron radiation scan and communicates the data to a processingsystem adapted to process the data and provide an image of histologicslice quality of at least a portion of the area of potential pathology.

These, as well as other components, steps, features, objectives,benefits, and advantages, will now become clear from a review of thefollowing detailed description of illustrative embodiments, theaccompanying drawings, and the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Advantages of the invention will be readily appreciated as the samebecomes better understood by reference to the following detaileddescription when considered in connection with the accompanyingdrawings, wherein:

FIG. 1 is a schematic-type perspective view of a first embodiment of aCT and synchrotron radiation cooperative scanning system of theinvention with a vertical CT scanner;

FIG. 2 is a schematic-type perspective view of a second embodiment of aCT and synchrotron radiation cooperative scanning system of theinvention with a C-Arm CT scanner;

FIG. 3 is a schematic-type perspective view of a third embodiment of aCT and synchrotron radiation cooperative scanning system of theinvention with a C-Arm CT scanner;

FIG. 4A is a schematic-type perspective view of a fourth embodiment of aCT and synchrotron radiation cooperative scanning system of theinvention with a horizontal CT scanner;

FIG. 4B is cutaway of the fourth embodiment of FIG. 4A along the lines4B-4B;

FIG. 5 is a flowchart of a first embodiment of a method of theinvention;

FIG. 6 is a flowchart of a second embodiment of the method of theinvention; and

FIG. 7 is a flowchart of a third embodiment of the method of theinvention.

For the purposes of promoting an understanding of the principles of theembodiments, reference will now be made to the embodiments illustratedin the drawings and specific language will be used to describe the same.It will nevertheless be understood that no limitation of the scope ofthe embodiments is thereby intended. Any alterations and furthermodifications in the described embodiments, and any further applicationsof the principles of the embodiments as described herein arecontemplated as would normally occur to one skilled in the art to whichthe embodiment relates.

DETAILED DESCRIPTION OF THE DRAWINGS

The present invention is a CT guided and synchrotron radiation performedradiographic biopsy system and method. The invention has severalsimilarities to a CT-guided biopsy. As mentioned previously, duringCT-guided biopsy, a needle is used to obtain a sample. However, incontradistinction, the proposed invention substitutes a needle with asynchrotron radiation-based image to ultimately obtain a “sample.” Thepresent invention combines a standard diagnostic CT to locate the areaof concern (ex. a lesion) and then subsequently apply synchrotronradiation to produce an image equivalent to a specimen that would beexamined on a slide. The combined system of conventional CT andsynchrotron radiation can be used to produce a histologic/pathologicslice thickness of any area of the human body (ex. the otic capsule ofthe inner ear, nephrons which are functional units of the kidney, etc).It is believed that there is wide beneficial application of theinvention. However, it seems that the described system and methods forperforming a radiologic biopsy have a particular utility in samplingpotentially cancerous lesions.

Important benefits of the invention include greater patient comfort,elimination of risks associated with needle biopsy such as infection ornerve damage, and reduced time to complete the procedure thus leading toquicker diagnoses.

The system and method include combining standard diagnostic CT typeradiation with synchrotron radiation to obtain histologic/pathologicslice thickness samples of subject's body. This certainly has a myriadof applications, but one of the primary applications is with regards toobtaining pathology samples, as in the case of image guided biopsies.The patient would undergo a standard preliminary CT scan to determinewhere the lesion is. Once determined, they would be moved to theappropriate position. Then the synchrotron beam can be used to passthrough that site and the “sample” could then be obtained that would beof histologic slice thickness.

Next, described is a general setup of the combined standardCT/synchrotron CT method and apparatus. There are multiple methods thatcan be used to combine a synchrotron radiation source andstandard/medical CT scanner into a single apparatus. The primaryutilities in combining the two in the manner described below is speed oflocalization, quality of image rivaling histologic studies, and lessburden on the patient. For most of the described embodiments it isassumed that synchrotron beamlines are in a fixed position relative tothe standard CT machine.

Option 1: Perform both the CT scan and synchrotron scan with a subjectin a vertically held position. In this embodiment, the subject andsample must be rotated along its long axis (such as on a rotisserie).Thus, a platform capable of rotating 360 degrees is used. As aconsequence of this rotation, it is easier to accomplish if the patientis standing or sitting.

In this scenario, the patient is placed in a vertically oriented CTscanner, with the synchrotron beam at an orthogonal angle relative tothe standard CT beam.

The patient will stand on a platform capable of moving vertically, aswell as in the Z direction. Additionally, the platform can rotate 360degrees. The CT scanner itself can be a dedicated vertical CT, avertically movable CT, or a C-Arm CT. The patient is advanced throughthe scanner vertically (as in a regular CT), in order to obtain the X-Y(i.e., transverse and craniocaudal dimensions respectively) coordinatesof a particular area of interest.

Once the patient is in the desired X-Y plane, the Z-coordinate (i.e.,depth or anteroposterior dimension) must be determined. There is morethan one way to calculate the Z-coordinate/depth known to those skilledin the art. One is manually (which is already done in CT-guidedbiopsies). A second method would be to rely on parallax shift. In thismethod, the C-Arm X-ray tube is used to generate a pair of images +15°and −15° relative to the 0° position. A third method is to use anautomated software to determine the depth and its reference to thesynchrotron beam. In this latter scenario, the region of interest couldbe selected, and the depth automatically calculated, and patienttranslated in the Z dimension to be in line with the synchrotron beam.

Once the X, Y, and Z coordinates are determined, the patient is moved tothe appropriate Z-plane which will be in the path of the synchrotronbeam. Once directly in the path of the synchrotron beam, the patient isrotated 180-360 degrees and a synchrotron-based image of the lesion inquestion is obtained (for example, on the microscopic or submicroscopicscale).

Option 2: Use a horizontally oriented standard CT scanner followed by asynchrotron scan. This method is likely possible but much morecumbersome because the patient must be rotated along their long axis,which requires support to keep the patient from falling off the bed. Theplatform (or gantry) can move forwards and backwards, and adjustheight/depth, as well as rotate along its long axis. Consideration isneeded so that supports do not obstruct the synchrotron beam. Theremainder of the steps are essentially the same as in the first option.

Certain measures can be put in place to reduce motion artifact duringscanning. These may include respiratory-cardio gating or physicalstabilizers such as straps or padding. In certain instances (such asscanning in the lung), active breath control can also be used.

Synchrotron beam flux and energy are tuned depending on the beam width,prior to synchrotron scanning, to ensure that the average energy issufficient to penetrate through the sample but low enough to allow fastscans. Energy tuning can be performed using various filters, such asmolybdenum and copper. Materials such as fused silica bar attenuatorsallow for adjusting the beam flux and profile. To preserve beamcoherence prior to scanning, filters and optics are made of high-qualitymirror polished materials (ex. Pf6/IF1 beryllium) to ensure materialhomogeneity (flux and beam profile tuning). Scintillators must be asdense as possible while not degrading the resolution. Briefly, ascintillator is a material that converts a radial ray such as an X-rayinto visible light. Thickness of the scintillators are optimized toprovide a compromise between light output and maximum optical resolutionfor each X-ray optic. The thickness of the scintillator results in atrade-off between absorption and spatial resolution. Thickerscintillators absorb a larger proportion of X-rays but allow for greaterscatter and therefore poorer spatial resolution. The reason thickerscintillators are preferred in synchrotron radiation is to optimizesignal (while obviously keeping spatial resolution at an acceptablerange). Various optics can be selected depending on the beam width (ex.25-6 μm/voxel). Photodarkening refers to an optical effect in theinteraction of laser radiation with amorphous media (ex. Glass) inoptical fibers. It limits the density of excitations in fiber lasers andamplifiers. In order to prevent optics darkening prior to scanning,particularly at smaller beam widths, optics can be intrinsicallyhardened with X-rays, or are protected from darkening using a thinglassy carbon mirror to reduce internal scattering and lead glass in thefront of an optic to stop as much scattering as possible. A beam stopcan be used to prevent beam back scatter during scanning. Morespecifically, it is meant to block the X-ray beam directly transmittedby the sample to protect the detector, as well as oversaturation of thedetector. In the case of a synchrotron, it can be made of a hollowtungsten cylinder. It is typically placed inside the flight tube justbefore the big Kapton window (Kapton is a polymer commonly used as amaterial for windows used with all kinds of X-ray sources. Its highmechanical and thermal stability as well as high transmittance of X-raysmake it the preferred material. It is also relatively insensitive toradiation damage). Curing can be performed after scanning in order toensure optics recovery, in the event of optics darkening. Curing refersto a photochemical process in which high-intensity ultraviolet light orLED light is used to instantly cure or “dry” inks, coatings oradhesives. It is used to initiate a photochemical reaction thatgenerates a crosslinked network of polymers.

Synchrotron scanning can be made to work similarly to conventional CTscanning in terms of how projections are reconstructed to create avirtual slice. Multiple projections are obtained while the specimen isrotated 180-360 degrees. To translate the data into a 2-D image,tomographic reconstruction is performed using algorithms already in usewith conventional CT. All reconstruction algorithms rely on a Radontransformation, which is represented by the function f(x, y) and can bedefined as a series of line integrals through f(x, y) at differentoffsets from the origin. This is defined mathematically as: whose valueat a particular line is equal to the line integral of the function overthat line: R(r,θ): =∫_(−∞) ^(∞)∫_(−∞) ^(∞)f(x,y)δ(x cos θ+y sin θ−r)dxdy).

There are several reconstruction algorithms that can be used. However,the most common include Fourier-Domain reconstruction, back/filter-backprojection and iterative reconstruction. These methods are known tothose skilled in the art as being used in synchrotron CT scanning,including microscopic applications. Artisans and their articlesdiscussing reconstruction algorithms and related issues include:Pacureanu, Imaging The Bone Cell Network With Nanoscale SynchrotronComputed Tomography, 2013, page 173; Schleede, Simone, X-rayPhase-Contrast Tomosynthesis For Improved Breast Tissue, EuropeanJournal of Radiology, 2013, pages 531-536; Zhao, Yuqing, An IterativeImage Reconstruction Algorithm combined with forward and backwarddiffusion filtering for in-line x-ray phase contrast ComputedTomography, Journal of Synchrotron Radiation, 2018, pages 1450-1459;Duan, Jinghao, High-Resolution Micro-CT for Morphologic and QuantitativeAssessment of the Sinusoid in Human Cavernous Hemangioma of the Liver,PLOS, 2013; Vagberg, William, X-ray Phase-Contrast Tomography forHigh-Spatial-Resolution Zebrafish Muscle Imaging, Scientific Reports;Bennink, Edwin, Influence of Thin Slice Reconstruction on CT BrainPerfusion Analysis, PLoS ONE; and Sprawls, Perry Physical Principles ofMedical Imaging. 2nd ed, Aspen Publishers, 1985. The above referencedresources are included here as illustrative of how and why thereconstruction algorithms are known to those skilled in the art.

For example, in filtered-back projection, the original image is μ(x, y)and the back-projection image is: f_(fbp)(x, y)=∫q0(x cos θ+y sin θ)dθwith qθ(t)∫p_(θ)(ω)|ω|e^(i2πωt)dω. It has also been demonstrated andknown, that using a filter back projection algorithm can eliminateartifacts such as blurring. It has also been shown that for thehigh-resolution imaging, the source-object-distance and theobject-detector-distance can be optimized to obtain the desiredmagnification onto the detector. The number of projections, step angleand exposure time per projection and a voxel size can be adjusted.

When a synchrotron beam passes through the specimen (for example a livepatient), it inevitably traverses the entire width of the patient atthat level. This means that when the synchrotron image is generated, itincludes not just the lesion in question, but also tissue along theentire trajectory of the synchrotron beam (i.e., tissue that is outsidethe area of interest). The issue then becomes determining what areaalong the length of the synchrotron image corresponds to the lesion seenon the conventional CT image. There are a few ways to resolve thisissue. In conventional CT, it is already known to those skilled in theart that thicker slices can be reconstructed from thinner slices (notvice versa however). Thus, one method is to reconstruct the synchrotronimage according to the same thickness as the conventional image and thendirect correlation to the conventional image can be made. A secondmethod known to those skilled in the art relies on the fact that theinitial conventional CT image is displayed as a grid of pixels, witheach pixel assigned certain X and Y coordinates. Additionally, a pixelhas a determined height and width (pixel size can be calculated bydividing the field of view by the matrix size). The area or lesion inquestion will correspond to a certain set of pixels (i.e., specific areaon the pixel grid). The synchrotron beam will already be localized toapproximately the Y dimension. The synchrotron pixel dimensions are alsoknown and therefore the absolute distance, or X dimension, can bedetermined from a common reference point. One can then calculate/convertthe synchrotron pixel distance that would correspond to that on theconventional CT image. A third method involves calibrating theoverlapping scan regions with gradual transition and normalization ofthe gray levels in the area common to the two scans.

The result is an image (or set of images) of comparable resolution andscale to substitute for a cellular or subcellular sample examined undera microscope. For example, if a patient was found to have anincidentally discovered pulmonary nodule on a conventional screening CTof the chest. The patient would then undergo radiologic biopsy, withlocalization and subsequent synchrotron scanning to obtain a histologiclevel slice thickness and scale to determine if malignant cells are infact present or not. An additional example would be in a patient withknown cirrhosis with an indeterminate liver lesion, questionable forhepatocellular carcinoma. Using the same process, it could be determinedif HCC is present or not. Radiologic biopsy could also be used innon-malignancy type cases. For example, in determining if there isongoing rejection versus some other process in renal transplant patientsor examining the inner ear (ex. cochlea) in patients with idiopathichearing loss.

Additional nonlimiting embodiments of the invention can use othersources of synchrotron radiation, such as a free electron laser (FEL),or alternatively, a more compact version of a synchrotron. In the caseof a FEL, it uses the same principal as a standard circular synchrotron.In that, synchrotron radiation is generated when a relativistic particleis accelerated in a direction perpendicular to their velocity. Where aFEL differs from a typical circular accelerator is that an electron beamtraversing an undulator interacts with a co-propagating photon beam ofthe correct wavelength which induces bunching of the electron beam,giving rise to coherent emission. In any of the above cases, whetherconventional circular accelerator, compact circular accelerator, or aFEL, the principal is the same, in that the synchrotron radiation sourceis used in cooperation with conventional CT.

As mentioned in a previous section, synchrotrons are large and few innumber, therefore limiting their availability. And as can be inferredfrom the previously proposed constructs, conventional CT seems to benecessarily “tethered” to the synchrotron. Consideration can thereforebe given to synchrotron radiation that is distant from its parentsource, i.e., untethering the synchrotron source in order to increaseavailability/access. One such proposed method involves the use offiberoptics which could theoretically transmit synchrotron radiationover long distances and thereby remove the need to be directly tetheredto a particle accelerator (i.e., siphoning synchrotron radiation). Themain challenges in transmitting synchrotron light over optical fibersrelate to what are called “coupling efficiency” and “dispersion” whichare introduced during propagation along the fiber. These two factors arestrictly correlated when one is trying to design such a system: sincethere are minimum requirements on the signal-to-noise ratio, if thecoupling efficiency is too low, one is forced to couple light on alarger bandwidth, which in turn makes the dispersion worse, for example.The basic components of a generic fiberoptics-based system include thesynchrotron light source, a couple/collimator, with or without a lightsampling component at the beginning of the fiber, and the sample at somepredetermined distance from the original source and at the end of thefiber propagation.

Now with reference to FIG. 1 , in a nonlimiting embodiment, a firstradiologic biopsy system 10 of the invention includes a vertical CTscanning system 12 and a vertical presenting stage/platform 14 forsupporting a patient (not shown) to be scanned. The CT scanning system12 is of the type well known to those of skill in the state of the artand is capable of providing slices of adequate resolution and toidentify an X, Y and Z coordinates of an area of a mass/lesion or otherpotential pathology warranting further investigation through biopsy. TheCT scanning system 12 is connected to, or otherwise in communicationwith a processing system 16 for receiving radiologic imaging data andprocessing it to produce radiographic slices of the subject of interest.The processing system 16 includes a computer system and software of thetype well known to those of skill in the art. The processing system 16is capable of taking data, including a dataset resulting from a CT scan,and process it into radiographic images reviewable by a radiologist andothers. The CT scanning system 12 includes a CT scanner 18 that may becapable of moving in a vertical direction 20, with the patient seated orstanding on the stage/platform 14. The platform 14 may also be capableof moving in a vertical direction 22, as well as in the X and Z-planedirections, in addition to moving rotationally 24. In an embodiment,only the stage/platform 14 will move and the CT scanner 18 will remainstationary. The movement of the stage/platform 14 is directed by anarticulating apparatus 26 capable of moving the stage/platform 14 atleast in a vertical direction, in the Z-plane, and rotationally. Thestage/platform 14 is depicted as one allowing for the subject to beseated in during the procedure. It is also possible for thestage/platform 14 to allow the subject to stand upright.

The radiologic biopsy system 10 further includes a synchrotron radiationsource 28. The synchrotron radiation source 28 includes at least asynchrotron such as the Canadian Light Source synchrotron located inSaskatoon in the Province of Saskatchewan, Canada or the NationalSynchrotron Light Source II (NSLS-II) at Brookhaven National Laboratory(BNL) in Upton, N.Y. Any other similarly equipped synchrotrons aresuitable. It is also anticipated that the synchrotron radiation source28 is an alternatively derived source for synchrotron radiation thatmeets the requirements for providing beamwidth and other characteristicssuitable for the intended purpose. Alternative synchrotron radiationsources are described above.

The synchrotron radiation source 28 generates synchrotron radiation to adirector 30 and then to an emitter 32. The director 30 and emitter 32are at least an aperture from the synchrotron or may be series ofreflectors, refractors, slits, collimators and radiation shutterscapable of directing and altering characteristics of the synchrotronradiation. As described above, in an alternative embodiment the director30 may also include fiberoptics suitable for directing the synchrotronradiation at a distance from the synchrotron radiation source 28.

Opposite of the emitter 32 is a receptor 34 for receiving the radiationafter passing through the subject. The receptor 34 is in communicationwith the processing system 16 for processing the data resulting from thesynchrotron radiation scan. The processing system 16 is illustrated asthe same for both the CT scanning system 12 and the synchrotronradiation source 28 but it should be understood that the systems couldbe separate. The processing system 16 includes computer hardware andsoftware known to those of skill in the art and is capable of takingdata including a dataset resulting from a synchrotron scan and processit into radiographic images reviewable by a radiologist and others.

In operation of the radiologic biopsy system 10, the subject, such as apatient with potential pathology warranting a biopsy study is positionedon the stage/platform 14 in a seated or standing position. The CTscanning system 12 is then activated to provide slices of the patientaround the area of interest. A review of the slices enables determininga more precise location requiring further study. This may be done by aradiologist. Next, an X, Y and Z coordinates of the area requiringfurther study are determined from the table position and the provided CTslices. The patient is then optimally positioned via the stage/platform14 to allow a synchrotron radiation 36 from the synchrotron radiationsource 28 to be radiated directly at the X, Y and Z coordinates of thearea requiring a biopsy. The data received from the receptor 34 is thenprocessed by the processing system 16. The radiologic biopsy system 10thereby provides a high-resolution scan of a very specific area of thesubject thus allows for looking at the tissue such as cells anddetermining if pathology is present. In this respect, the system allowsfor performing an important medical procedure without the invasivenessand risk associated with a needle biopsy.

Referring to FIG. 2 , in a nonlimiting embodiment, a second radiologicbiopsy system 50 of the invention includes a C-Arm CT scanning system 52and a vertical presenting stage/platform 54 for supporting a patient 56to be scanned. The C-Arm CT scanning system 52 is of the type well knownto those of skill in the state of the art and can provide slices ofadequate resolution and to identify an X, Y and Z coordinates of an areaof a mass or other potential pathology warranting further investigationthrough biopsy. The C-Arm CT scanning system 52 offers the advantage ofnot including a fully circular apparatus around the patent thusproviding easier access for integrating with a synchrotron radiationsource. The C-Arm CT scanning system 52 is connected to, or otherwise incommunication with a processing system 16 for receiving radiologicimaging data and processing it to produce radiologic slices of thesubject of interest. The C-Arm CT scanning system 52 includes a CTscanner 58 which has a connecting element capable of movinghorizontally, vertically and around the swivel axes, so that X-rayimages of the patient can be produced from almost any angle. Thestage/platform 54 can move in a X, Y and Z direction 60, in addition tomoving rotationally 62. The movement of the CT scanner 58 is directed byan articulating apparatus 64 capable of moving the CT scanner at leastin a vertical direction. The stage/platform 54 is depicted with thepatient 56 standing on the stage/platform but could also include avertically oriented stage/platform for holding the patient in place withthe patent's back to the stage/platform 54. The stage/platform 54includes technology known to those skilled in the art and is capable ofprecise and steady movements to help reduce motion artifact.

The radiologic biopsy system 50 further includes a synchrotron radiationsource 28. The synchrotron radiation source 28 includes any of thesources as previously described. The synchrotron radiation source 28generates synchrotron radiation to the director 30 and then to theemitter 32. The director 30 and emitter 32 are at least an aperture fromthe synchrotron or may be series of reflectors, refractors, slits,collimators and radiation shutters capable of directing and alteringcharacteristics of the synchrotron radiation. As described above, in analternative embodiment the director 30 may also include fiberopticssuitable for directing the synchrotron radiation at a distance from thesynchrotron radiation source 28.

Opposite of the emitter 32 is a receptor 34 for receiving the radiationafter passing through the patient 56. The receptor 34 is incommunication with the processing system 16 for processing the dataresulting from the synchrotron radiation scan. The arm 66 of the CTscanner 58 includes an aperture 68 of suitable size to allow thesynchrotron radiation 36 to pass through the arm 66 and reach thereceptor 34. The aperture 68 could be an actual opening or anunobstructed pathway including where a material is used that will notsignificantly interfere with the synchrotron radiation. The CT scanner58 includes an X-ray emitter 70 and an X-ray receptor 72 opposite theX-ray emitter 70. The X-ray emitter 70 emits X-rays 74 in a directionthrough the patient 56 to identify the area of interest.

In operation of this nonlimiting embodiment of the radiologic biopsysystem 50, the patient 56 requiring a biopsy is positioned on thestage/platform 54 in a seated or standing position. The C-Arm CTscanning system 52 is then activated to provide radiographic slices ofthe patient around the area of interest. A review of the slices enablesdetermining a more precise location in the patient requiring furtherstudy. This may be done by a radiologist. The C-Arm CT scanning system52 determines an X, Y, and Z coordinates of the area requiring furtherstudy. The patient is then moved via the stage/platform 54 so that thesynchrotron radiation 36 from the synchrotron radiation source 28 isradiated directly at or near the X, Y and Z coordinates of the arearequiring a biopsy. The CT scanner 58 is positioned to allow thesynchrotron radiation 36 to be orthogonal to the CT scanner radiation 74so that synchrotron radiation passes through the aperture 68. The datareceived from the receptor 34 is then processed by the processing system16. The radiologic biopsy system 50 thereby provides a high-resolutionscan of a very specific area of the patient thus allows for looking atthe tissue such as cells and determining if pathology is present.

Importantly, in this embodiment, movement of the CT scanner 58 incooperation with movement of the stage/gantry 54 allows for positioningthe patient 56 precisely such that both the CT scan and synchrotronradiation scan can be performed simultaneously in the area to bebiopsied. After the patient 56 is in the appropriate position to performthe synchrotron radiation scan both the CT scan and synchrotronradiation scan can take place concurrently or in phases to identify andfocus in on the area requiring biopsy. Further, during both the CT scanand synchrotron radiation scan the patient can be rotated onstage/platform 54 to allow for correlating the image and providing atleast a 2-D image where the synchrotron radiation scan provides ahistologic (microscopic) slice thickness of the area of interestresulting in a radiographic biopsy.

Now with reference to FIG. 3 , in another nonlimiting embodiment, athird radiologic biopsy system 80 of the invention is similar to what isdescribed in relation to FIG. 2 , but with the synchrotron radiationsource 28 and receptor 34 being aligned relative to the X-ray emitter 70and an X-ray receptor 72 so that the synchrotron radiation 36 will beparallel to the CT scanner radiation 74. In this embodiment, nomodification to the C-Arm CT scanning system 52 is needed to allow thesynchrotron radiation to traverse the patient 56.

In operation of the radiologic biopsy system 80, the patient 56requiring a biopsy is positioned on the stage/platform 54 in a seated orstanding position. As described in relation to FIG. 2 , the C-Arm CTscanning system 52 is then activated to provide slices of the patientaround the area of interest and review of the slices enables determininga more precise location in the patient requiring further study. In thisembodiment, the patient 56 is then moved via the stage/platform 54 up ordown so that the synchrotron radiation 36 from the synchrotron radiationsource 28 is radiated directly at or proximate the X, Y and Zcoordinates of the area requiring a biopsy. In this embodiment, movementof the CT scanner 58 in cooperation with movement of the stage/platform54 allows for positioning the patient 56 precisely such that the CT scanand synchrotron radiation scan can be performed in close sequence, firstby CT scan to isolate the area of interest and then moving the patientat least linearly up or down to accommodate the distance between the CTscan beam and the synchrotron scan beam to perform the synchrotronradiation scan on the area requiring biopsy. Once in position, duringsynchrotron radiation scan the patient can be rotated on thestage/platform 54 to allow for correlating the image and providing atleast a 2-D image where the synchrotron radiation scan provides ahistologic (microscopic or submicroscopic) slice thickness of the areaof interest resulting in a radiographic biopsy.

With reference to FIGS. 4A and 4B, in yet another nonlimitingembodiment, a fourth radiologic biopsy system 90 of the inventionincludes a horizontal CT scanning system 92 and a horizontal bed 94 forsupporting the patient 56 to be scanned. The horizontal bed 94 can movein at least an X, Y and Z direction. The bed 94 may also be able torotate in a rotisserie-type manner around an axis perpendicular to aplane CT scanning system 92.

The horizontal CT scanning system 90 is of the type well known to thoseof skill in the art and is capable of providing slices of adequateresolution and to identify an X, Y and Z coordinates of an area of amass or other potential pathology warranting further investigationthrough biopsy. Similar to the C-Arm CT scanning system described inreference to FIG. 2 , the system is connected to or otherwise incommunication with a processing system (not shown) for receivingradiologic imaging data and processing it to produce radiologic slicesof the patient.

The horizontal CT scanning system 90 includes a first and secondaperture 96 a, 96 b for allowing synchrotron radiation 36 to passthrough part of a housing 98 of the horizontal CT scanning system 90.Advantageously, the first and second aperture 96 a, 96 b may be a trueaperture or a portion of the housing 98 with no obstacles or other X-rayinterfering properties. In this embodiment, CT scan X-rays 74 areorthogonal to the synchrotron radiation 36.

In operation of this nonlimiting embodiment of the radiologic biopsysystem 90, the patient 56 requiring a biopsy is positioned on the bed 94in either a prone or supine position. The horizontal CT scanning system92 is then activated to provide slices of the patient around the area ofinterest. A review of the slices enables determining a more preciselocation in the patient requiring further study. The system 90determines an X, Y, and Z coordinates of the area requiring furtherstudy. The patient is then moved via the bed 94 so that the synchrotronradiation 36 from the synchrotron radiation source 28 is radiateddirectly at the X, Y and Z coordinates of the area requiring a biopsy.Due to the configuration of the system 90 the horizontal CT scanner 92is positioned to allow the synchrotron radiation 36 to be orthogonal tothe CT scanner radiation 74 as the synchrotron radiation passes throughthe apertures 96 a, 96 b. The data received from the receptor 34 is thenprocessed by the processing system. The radiologic biopsy system 90thereby provides a high-resolution scan of a very specific area of thepatient thus allows for looking at the tissue such as cells anddetermining if pathology is present.

In this embodiment, movement of the bed 94 allows for positioning thepatient 56 precisely such that both the CT scan and synchrotronradiation scan can be performed simultaneously in the area to bebiopsied. After the patient 56 is in the appropriate position to performthe synchrotron radiation scan both the CT scan and synchrotronradiation scan can take place concurrently or in phases to identify andfocus in on the area requiring biopsy. Further, during both the CT scanand synchrotron radiation scan the patient can be moved and/or rotatedon the bed 94 to allow for correlating the image and providing at leasta 2-D image where the synchrotron radiation scan provides a histologic(microscopic) slice thickness of the area of interest resulting in aradiographic biopsy. If the patient is rotated on the bed 94 it will benecessary to include stabilizing means to hold the patient in place.

With reference to FIG. 5 , a nonlimiting embodiment of the method of theinvention 100 begins with scanning a patient 102, a living humansubject, with a CT scanning system. Any of the described CT scanningsystems (refer to FIGS. 1-4 ) are suitable for this step. The next step104 includes identifying with the CT scan an area of interest for biopsysuch as a potential lesion and determining the X, Y and Z coordinates ofthe area of interest. Next, in step 106, positioning the patent, ifnecessary, for a synchrotron scan and performing a synchrotron scan. Thenext step 108 includes, obtaining a dataset of micron or sub-micronresolution images from the scanning with the synchrotron radiationsource. The data is developed from the synchrotron scan. The next step110 includes, computer enabled resolving of the dataset to derivecellular or subcellular level resolution of at least a portion of thearea of potential pathology. The last step 112 includes, reviewing theimages for evidence of pathology. Following these steps provides aradiologic biopsy of the patient.

In a nonlimiting embodiment, the method 100 further includes the step114 of concurrent or sequential scanning with the CT scanner and thesynchrotron scan. As already described in reference to FIGS. 2-4 ,certain embodiments of the radiologic biopsy system allow for concurrentCT scanning and synchrotron scanning. In this embodiment, the patient ispositioned such that both the CT scan and the synchrotron scan can befocused on approximately the same X, Y, and Z coordinates of the patientwhere the potential lesion or other area of interest is located. Abenefit of this arrangement is the ability to adjust the position of thepatient while reviewing scout images from the CT scan in real-time toallow for more precise positioning of the patient for the synchrotronscan of the area of interest.

Referring to FIG. 6 , a second nonlimiting embodiment, the steps of amethod of performing a radiological biopsy 150 of the invention includesa first step 152 of scanning a living human subject with a CT scan tolocate the coordinates of an area of potential pathology and then usingthe coordinates to direct synchrotron radiation to obtain ahigh-resolution image of the area of potential pathology. This begins atstep 154 with obtaining a CT scan scout image. Next, in step 156, fromthe scout image, a few key landmarks are used to roughly determine whatlevel the area of concern is located and what area to scan. A subsectionis blocked off for slice acquisition. Next, in step 158 usingconventional CT, a number of slices are obtained while the patient tableis translated through the gantry in a craniocaudal manner. The idealslice position is selected which displays the desired location to biopsyand the table is moved to that position. The remaining locations of thelesion can be determined from the image itself. In step 160, once the X,Y, Z coordinates are determined by conventional CT scan, the patient istranslated so that the lesion may be aligned with the synchrotron beamand permit scanning by synchrotron radiation. In step 162, in order toensure that the level in question is directly aligned with thesynchrotron beam, fiducial markers can be placed above and below thesynchrotron aperture as the beam enters the inner part of theconventional CT gantry to ensure that it is in line with the desiredlevel of scanning. Next, in step 164, once directly in the path of thesynchrotron beam, the patient is rotated 180-360 degrees and asynchrotron-based image of the lesion in question is obtained. In thecase of the horizontal method as described above in reference to FIGS.4A and 4B, supports must be used to prevent the patient from falling offthe bed. During synchrotron scanning, multiple projections are obtainedwhile the specimen is rotated 180-360 degrees. Next, in step 166 datafrom the synchrotron scan is translated into a 2-D image, withtomographic reconstruction performed using algorithms already in usewith conventional CT and previously described above. In step 168,correlation from the conventional CT image to the slice obtained viasynchrotron is made to determine the location of the lesion in questionusing methods already described. In step 170, the 2-D generated imagesfrom the synchrotron scan are read for potential pathology.

Referring to FIG. 7 , in a nonlimiting embodiment a method of theinvention includes steps for preparing to perform and performing thesynchrotron scan 180. At step 182, the synchrotron beam flux and energyare tuned prior to the procedure to ensure optimal average energysufficient to penetrate through the patient but low enough to allow morerapid scans. Tuning can be achieved using filters such as molybdenum andcopper filters for energy tuning. Fused silica bar attenuators allow foradjusting the beam flux and profile. Next, at step 184, prior to theprocedure, beam coherence is preserved using filters and optics. Filtersand optics are made of high-quality mirror polished materials. Opticscan be made of pf6/IF1 beryllium for example. Scintillators are selectedto be as dense as possible while not degrading resolution. At step 186,prevention of optics darkening is performed during scanning.Photodarkening can be prevented by intrinsic hardening by X-rays.Alternatively, darkening can be reduced through the use of a thin glassycarbon mirror to reduce internal scattering and lead glass in the frontof an optic to stop as much scattering as possible. A beam stop can beused to prevent beam back scatter during scanning. In the case of asynchrotron, it can be made of a hollow tungsten cylinder. It istypically placed inside the flight tube just before the big Kaptonwindow. In step, 188 following scanning, curing can be performed toensure optics recovery, in the event of optics darkening.

The invention has been shown and described in what is considerednonlimiting embodiments. It is recognized that departures may be madewithin the scope of the invention and that modifications will occur to aperson skilled in the art. With respect to the above description then,it is to be realized that the optimum dimensional relationships for theparts of the invention, to include variations in size, materials, shape,form, function and manner of operation, assembly, and use, are deemedreadily apparent and obvious to one skilled in the art, and allequivalent relationships to those illustrated in the drawings anddescribed in the specification are intended to be encompassed by thepresent invention.

The invention has been described in an illustrative manner. It is to beunderstood that the terminology, which has been used, is intended to bein the nature of words of description rather than of limitation. Manymodifications and variations of the invention are possible in light ofthe above teachings. Therefore, within the scope of the appended claims,the invention may be practiced other than as specifically described.

What is claimed is:
 1. A method of performing a radiologic biopsy,comprising: scanning a living human subject with a CT scanner andobtaining CT scan images of the living human subject; identifying in theCT scan images a localized area of potential pathology; identifying withthe CT scanner an X, Y and Z coordinates within said area of potentialpathology; scanning with a synchrotron radiation said area of potentialpathology at, or proximate to said X, Y and Z coordinates; obtaining adataset of sub-micron resolution image data from said scanning with saidsynchrotron radiation; and resolving of said dataset to produce aradiographic image having cellular level resolution of at least aportion of said area of potential pathology.
 2. The method of performinga radiologic biopsy of claim 1, further comprising: algorithmicallyreducing motion artifact during said scanning with said synchrotronradiation.
 3. The method of performing a radiologic biopsy of claim 1,further comprising: repositioning the living human subject before thestep of scanning with said synchrotron radiation to line up the X, Y andZ coordinates of said area of potential pathology with a beam of saidsynchrotron radiation.
 4. The method of performing a radiologic biopsyof claim 1, further comprising: during the step of scanning with saidsynchrotron radiation, rotating the living human subject.
 5. The methodof performing a radiologic biopsy of claim 1, wherein the steps ofscanning the living human subject with a CT scanner and scanning withsaid synchrotron radiation are at least in part performed concurrently.6. The method of performing a radiologic biopsy of claim 1, wherein saidradiographic image is of comparable quality to a histologic slice of atleast a portion of said area of potential pathology.
 7. The method ofperforming a radiologic biopsy of claim 1, further comprising: tuning asynchrotron beam flux and energy from said synchrotron radiation priorto the step of scanning with said synchrotron radiation to ensure thatthe average energy is sufficient to penetrate through the living humansubject but low enough to allow fast scans.
 8. The method of performinga radiologic biopsy of claim 1, wherein the CT scanner is a C-Arm CTscanner, wherein said C-Arm CT scanner includes an unobstructed pathwayfor allowing a synchrotron radiation beam from said synchrotronradiation to traverse said unobstructed pathway, wherein a direction ofsaid synchrotron radiation beam and a direction of said scanning of saidCT scanner are orthogonal.
 9. The method of performing a radiologicbiopsy of claim 8, wherein the steps of scanning the living humansubject with a CT scanner and scanning with said synchrotron radiationare at least in part performed concurrently while said synchrotronradiation beam traverses said unobstructed pathway.
 10. The method ofperforming a radiologic biopsy of claim 1, wherein the CT scanner is ahorizontal CT scanner, wherein said horizontal CT scanner has anunobstructed pathway for allowing a synchrotron radiation beam from saidsynchrotron radiation to traverse said unobstructed pathway.
 11. Themethod of performing a radiologic biopsy of claim 1, wherein the CTscanner is a horizontal CT scanner, wherein the living human subject issupported on a horizontal stage, wherein the horizontal stage is movablein an X, Y and Z direction, wherein the horizontal stage is adapted torotate in a rotisserie-type manner around an axis perpendicular to aplane of the horizontal CT scanner.
 12. The method of performing aradiologic biopsy of claim 1 further comprising: reviewing saidradiographic image for evidence of pathology.
 13. A method of performinga radiologic biopsy, comprising: scanning a living human subject with aCT scanner and obtaining CT scan images of the living human subject;identifying in the CT scan images a localized area of potentialpathology and an X, Y and Z coordinates within said area of potentialpathology; scanning with a synchrotron radiation said area of potentialpathology at, or proximate to said X, Y and Z coordinates; obtaining adataset of sub-micron resolution image data from said scanning with saidsynchrotron radiation; and resolving of said dataset to produce aradiographic image having cellular level resolution of at least aportion of said area of potential pathology.
 14. The method ofperforming a radiologic biopsy of claim 13, further comprising:algorithmically reducing motion artifact during said scanning with saidsynchrotron radiation.
 15. The method of performing a radiologic biopsyof claim 13, further comprising: wherein said living human subject is ona movable stage; moving said stage while scanning with said synchrotronradiation.
 16. The method of performing a radiologic biopsy of claim 15,wherein said movable stage is adapted to controllably move so as toreduce a potential of motion artifact.
 17. The method of performing aradiologic biopsy of claim 13 further comprising: reviewing saidradiographic image for evidence of pathology.
 18. A method of performinga radiologic biopsy, comprising: positioning a living human subject on acontrollably movable stage; scanning the living human subject with a CTscanner and obtaining CT scan images of the living human subject;identifying in the CT scan images a localized area of potentialpathology and an X, Y and Z coordinates within said area of potentialpathology; at least one of moving said controllably movable stage andmoving a synchrotron radiation beam source while scanning with asynchrotron radiation said area of potential pathology at, or proximateto said X, Y and Z coordinates; obtaining a dataset of sub-micronresolution image data from said scanning with said synchrotronradiation; and resolving of said dataset to produce a radiographic imagehaving cellular level resolution of at least a portion of said area ofpotential pathology.
 19. The method of performing a radiologic biopsy ofclaim 18, further comprising: algorithmically reducing motion artifactduring said scanning with said synchrotron radiation.
 20. The method ofperforming a radiologic biopsy of claim 18 further comprising: reviewingsaid radiographic image for evidence of pathology.